Leading the Way in Ending TB
USAID’s local partners help countries regain lost ground in global TB efforts
Simon Peter Lobong is a Village Health Team member delivering TB services in Uganda’s Karamoja region. / USAID
USAID leads the U.S. Government’s global tuberculosis (TB) efforts, working with countries and partners to alleviate suffering from one of the world’s oldest infectious diseases. Our most critical partners in this fight are grassroots local organizations in high TB burden countries. These organizations are community-based and are often represented by individuals affected the most by TB.
In Africa, almost 60 percent of USAID’s country funding is implemented directly by these in-country partners, who play central roles in delivering on-the-ground solutions to maintain and expand TB services, ensure access to new technologies and treatment regimens, and get the world closer to achieving the Sustainable Development Goal (SDG) of ending TB by 2030.
USAID trained community members in Karamoja, Uganda to screen people for TB, collect samples for testing, and help those with TB stay on treatment and make medical appointments. / USAID
The remote region of Karamoja, Uganda has the country’s highest burden of TB at a devastating 315 cases per 100,000 people (compared to the national estimate of 154 cases per 100,000). People in the region traditionally live communally in enclosed homesteads, which due to crowding and poor ventilation, place them at increased risk of TB.
Recognizing the region’s TB service delivery challenges, the local partner, USAID’s Program for Accelerated Control of TB in Karamoja, developed a community-specific approach to address this deadly airborne disease. They trained community members to screen people for TB, collect samples for testing, and help those with TB stay on treatment and make medical appointments.
“We are trained to help and identify people with TB in our communities,” says Simon Peter Lobong, a Village Health Team member. “People know us because we are part of them. But to be trusted, one needs to be a good listener and maintain confidentiality to prevent stigma.”
These efforts drove a 52% increase in the number of TB cases identified in the region in 2021, compared to two years before, contributing to the country’s overall recovery from COVID-19’s negative impact on finding people with TB.
Truenat diagnostic instruments are used in a TB case finding activity in the Philippines.
USAID’s IDDS project
In countries like the Philippines and Nigeria, local partners have been integral in introducing new TB technologies at the primary health care level, including Truenat diagnostic instruments to test for TB and drug-resistant TB (DR-TB).
Truenat systems have batteries that last for eight hours; can be used in temperatures up to 104 degrees Fahrenheit; and can transmit results via SIM card, wifi, or Bluetooth — enabling them to be used in remote locations that previously had no access to high-quality TB testing. Since 2021, USAID has supported more than 150,000 Truenat tests in nine countries, yielding more than 16,300 people diagnosed with TB.
Truenat diagnostic instruments are used in a TB case finding activity in the Philippines.
USAID’s IDDS project
In addition to helping diagnose people with TB more quickly, USAID’s local partners have played an important part in supporting these individuals through lengthy and toxic treatment regimens.
To improve individuals with DR-TB’s chance of being cured, USAID local partners have helped introduce a shorter, less toxic treatment that can be taken orally–enabling people to take medication at home instead of traveling to health facilities for daily, hard-to-tolerate injectables. USAID has supported countries in increasing access to this treatment by 33 percent from 2020 to 2021.
A mobile team of doctors and nurses visits Oeurn Heur at home to support him throughout his treatment for a drug-resistant form of TB. / COMMIT
In Cambodia, a local partner has enrolled individuals like Oeurn Heur, a married 46-year-old father of three, on all-oral DR-TB treatment. After being diagnosed with a drug-resistant form of TB, the partner provided Oeurn with counseling and education about his treatment, then sent him home to return to his family the same day. While Oeurn experienced side effects, such as severe vomiting and anorexia during the first few months on medication, the continuous support he received enabled him to stay at home throughout his treatment.
A mobile team of doctors, nurses, and field workers frequently visited Oeurne to manage any worsening symptoms and side effects, as well as provide counseling and support. This enabled him to regain weight and successfully complete treatment. Initiatives like these have contributed to 83% of all Cambodians on DR-TB treatment successfully completing treatment in 2021, an increase from the prior year.
While much work remains, the on-the-ground efforts of USAID’s local partners–combined with the availability and introduction of new diagnostic tools, more efficient treatment regimens, and other innovations– show that with increased efforts and commitment, we can alleviate suffering from this curable disease and achieve the SDG of ending TB by 2030.
About the Author
Andrea Gavin is the Senior Communications Advisor for Tuberculosis in the Infectious Disease Office in USAID’s Bureau for Global Health.